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The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality

Author

Listed:
  • Alex Hollingsworth
  • Krzysztof Karbownik
  • Melissa A. Thomasson
  • Anthony Wray

Abstract

We explore how access to modern hospitals and medicine affects mortality by leveraging efforts of The Duke Endowment to modernize hospitals in the early-twentieth century. The Endowment helped communities build and expand hospitals, obtain state-of-the-art medical technology, attract qualified medical personnel, and refine management practices. We find that Duke support increased the size and quality of the medical sector, fostering growth in not-for-profit hospitals and high-quality physicians. Duke funding reduced both infant mortality - with larger effects for Black infants than White infants - and long-run mortality. Finally, we find that communities aided by Duke benefited more from medical innovations.

Suggested Citation

  • Alex Hollingsworth & Krzysztof Karbownik & Melissa A. Thomasson & Anthony Wray, 2022. "The Gift of a Lifetime: The Hospital, Modern Medicine, and Mortality," NBER Working Papers 30663, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:30663
    Note: CH DAE EH
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    Cited by:

    1. Agostino Capponi & Zhaonan Qu, 2025. "Handling Sparse Non-negative Data in Finance," Papers 2509.01478, arXiv.org.
    2. Ager, Philipp & Hansen, Casper Worm & Lin, Peter Z., 2023. "Medical Technology and Life Expectancy: Evidence from the Antitoxin Treatment of Diphtheria," CEPR Discussion Papers 18350, C.E.P.R. Discussion Papers.
    3. Sonia R. Bhalotra & Damian Clarke & Atheendar Venkataramani, 2025. "The Long Run Economic Effects of Medical Innovation and the Role of Opportunities," NBER Working Papers 34606, National Bureau of Economic Research, Inc.
    4. Michael Haylock & Martin Karlsson & Maksym Obrizan, 2024. "Pollution and Mortality: Evidence from early 20th Century Sweden," Papers 2412.01532, arXiv.org, revised Dec 2024.
    5. Karger, Ezra & Wray, Anthony, 2024. "The Black–white lifetime earnings gap," Explorations in Economic History, Elsevier, vol. 94(C).
    6. Jacks, David S. & Pendakur, Krishna & Shigeoka, Hitoshi & Wray, Anthony, 2024. "Later-life mortality and the repeal of federal prohibition," Journal of Public Economics, Elsevier, vol. 238(C).
    7. Aline Bütikofer & Rita Ginja & Krzysztof Karbownik & Fanny Landaud, 2024. "(Breaking) Intergenerational Transmission of Mental Health," Journal of Human Resources, University of Wisconsin Press, vol. 59(S), pages 108-151.

    More about this item

    JEL classification:

    • I14 - Health, Education, and Welfare - - Health - - - Health and Inequality
    • J13 - Labor and Demographic Economics - - Demographic Economics - - - Fertility; Family Planning; Child Care; Children; Youth
    • N32 - Economic History - - Labor and Consumers, Demography, Education, Health, Welfare, Income, Wealth, Religion, and Philanthropy - - - U.S.; Canada: 1913-

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